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» A AMC MAGA Z I N E | L AT E F A L L 2 014
Choosing Wisely
For a free
Sleeping Well
booklet, visit
askAAMC.org/Magazine
or call
443-481-5555
.
Nearly one-third of older people in the U.S. take
sleeping pills. These drugs are called sedative
hypnotics or tranquilizers. They affect the brain
and spinal cord.
“Doctors prescribe the drugs for sleep
problems,” says Ira Weinstein, MD, a
pulmonologist who specializes in sleep disorders.
“The drugs are also used to treat conditions such
as anxiety or alcohol withdrawal.”
But according to the American Geriatrics Society, there are safer
and better ways to improve sleep or reduce anxiety. Here’s why:
Sleeping pills may not help much.
Many ads say that sleeping
pills help people get a full, restful night’s sleep. But studies show
that, on average, people who take one of these drugs sleep only a
little longer and better than those who don’t take a drug.
Sleeping pills can have serious or even deadly side effects.
All
sedative-hypnotic drugs have special risks for older adults. Seniors
are likely to be more sensitive to their effects than younger adults.
And these drugs may stay in older people’s bodies longer.
“The drugs can cause confusion and memory problems that more
than double the risk of falls and hip fractures,” says Dr. Weinstein.
These are common causes of hospitalization and death in older
people. They also can increase the risk of car accidents.
Over-the-counter drugs may not be a good choice.
Side effects
of some drugs can be especially bothersome for seniors: next-day
drowsiness, confusion, constipation, dry mouth, and difficulty
urinating. Drugs to avoid include
diphenhydramine (Benadryl
Allergy, Nytol, Sominex, and generic),
doxylamine (Unisom and
generic), Advil PM, and Tylenol PM.
Try non-drug treatments first
Sleep problems can be caused by depression or anxiety, pain, restless
legs syndrome, and many other conditions. So if you’re having
trouble sleeping, see your doctor for a full medical exam. Even if an
exam does not turn up an underlying cause, you should try other
solutions before you try drugs.
“Only consider these drugs if the sleep problems are affecting
your quality of life and nothing else has helped,” Dr. Weinstein says.
“But your healthcare provider should watch you carefully to make
sure that the drug is helping and not causing bad side effects.”
For a list of sleeping pills that have risks, especially for
older adults, visit
askAAMC.org/ChoosingWisely
.
Source: ChoosingWisely.org
Exercise.
Physical activity helps
people sleep better. But avoid
vigorous activity for several hours
before bedtime.
Keep a routine.
Try to go to bed
and wake up at about the same time
every day, even on weekends.
Try not to eat at bedtime.
Eat three
hours or more before going to bed.
and Anxiety in Older People
Insomnia
Sleeping pills are usually not the best solution
To learn about
AAMC’s Sleep Center and take
a sleep quiz, visit
askAAMC.org/Sleep
.
Ira Weinstein, MD
Tips for better sleep
Avoid caffeine after 3pm.
Some people need to avoid caffeine
even earlier.
Limit alcohol.
Alcohol causes
sleepiness at first, followed
by wakefulness.
Create the right environment.
Keep the bedroom peaceful. And avoid
mental excitement before bedtime.
Avoid bright lights.
Watching a
bright screen can make you stay awake.
Control pets.
Pets disrupt sleep if they
are on and off the bed, taking up space, or
wanting to be let out.
If you don’t fall asleep soon, get out of
bed and do something that will make you
sleepy, such as
reading. Return to
bed after you start
to feel drowsy.
Source: ChoosingWisely.org
